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Ultrasound demonstration of mammographically detected microcalcifications in patients with ductal carcinomain situ of the breast

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Abstract

Background

Breast microcalcifications are difficult to depict by ultrasound (US). However, recent advances in US equipment and the refinement of breast imaging techniques have improved the detection and characterization of small breast lesions. The present study attempts to determine whether US examination is able to demonstrate nonpalpable breast lesions associated with mammographically detected microcalcifications without mass density or distortion, and to evaluate the clinical reliability of US-guided procedures, especially in cases of ductal carcinomain situ (DCIS) of the breast.

Methods

The subjects consisted of 73 patients with breast cancer diagnosed preoperatively as DCIS by stereotactic core needle biopsies, all of whom had microcalcifications without other abnormalities on mammography. The radiological appearance and size of the clustered microcalcifications were evaluated. US examinations were performed preoperatively, and the detection rates were assessed. Sonographically detected lesions underwent US-guided wire localization followed by surgical excision.

Results

The lesions associated with microcalcifications were identified sonographically in 54 of 73 cases (74%), and the pathological examination revealed breast cancer in all of the corresponding specimens. Lesions with linear-branching shape, segmental-linear distribution and category-5 calcifications on mammography had a high level of visibility on US. The US visible cases had a larger size of calcified area on mammography when compared with US invisible cases. Pathologically, the lesions were more frequently seen on US in cases with minimally invasive cancer or with comedo type DCIS.

Conclusions

US examination is an effective method for identifying and localizing breast microcalcifications, and can be used as an alternative to stereotactic localization in selected patients with early breast cancer.

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Abbreviations

DCIS:

Ductal carcinomain situ

US:

Ultrasound

BI-RADS:

Breast Imaging Reporting and Data System

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Authors and Affiliations

  1. Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, 260-0856, Chiba, Japan

    Takeshi Nagashima, Keiko Oshida, Shigeharu Nakano, Naoto Tanabe, Keiji Koda & Masaru Miyazaki

  2. Chiba Cancer Screening Center, Japan

    Hideyuki Hashimoto

  3. Division of Diagnostic Pathology, Chiba University Hospital, Chiba, Japan

    Takashi Nikaido

Authors
  1. Takeshi Nagashima
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  2. Hideyuki Hashimoto
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  3. Keiko Oshida
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  4. Shigeharu Nakano
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  5. Naoto Tanabe
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  6. Takashi Nikaido
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  7. Keiji Koda
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  8. Masaru Miyazaki
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Nagashima, T., Hashimoto, H., Oshida, K. et al. Ultrasound demonstration of mammographically detected microcalcifications in patients with ductal carcinomain situ of the breast. Breast Cancer 12, 216–220 (2005). https://doi.org/10.2325/jbcs.12.216

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  • DOI: https://doi.org/10.2325/jbcs.12.216

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